2012-03-02T15:38:18-06:00 2010-12-31 990 2010-01-01 742052197 SCOTT & WHITE HEALTH PLAN SCOT 2542983568 2401 S 31ST STREET TEMPLE TX 76508 MARINAN RENZ WILLIAMS 2542983034 2012-03-01 2010 2016-02-24 21:20:13Z MARINAN RENZ WILLIAMS 2401 S 31ST STREET TEMPLE TX 76508 642600835 0 X WWW.SWHP.ORG X 1979 TX TO PROVIDE THE MOST PERSONALIZED, COMPREHENSIVE, AND HIGHEST QUALITY HEALTHCARE, ENHANCED BY MEDICAL EDUCATION AND RESEARCH. 12 10 0 0 5971888 167490 18100000 0 625747116 560872544 2436502 1743067 13809508 11950206 660093126 574565817 0 0 573990456 495674395 0 0 0 0 0 72834833 81854452 646825289 577528847 13267837 -2963030 156100770 154462168 83879715 83856137 72221055 70606031 X TO PROVIDE THE MOST PERSONALIZED, COMPREHENSIVE, AND HIGHEST QUALITY HEALTHCARE, ENHANCED BY MEDICAL EDUCATION AND RESEARCH. 0 0 511554060 550034841 THE OPERATION OF A HEALTH MAINTENANCE ORGANIZATION (HMO) PROVIDING PREPAID MEDICAL CARE TO ITS MEMBERS. PAYMENTS RECEIVED FROM MEMBERS OR PAYORS (INCLUDING EMPLOYERS, INDIVIDUALS, FEDERAL, AND STATE AUTHORITIES) ON BEHALF OF MEMBERS IN CONSIDERATION FOR THE PROVISION OF MEDICAL SERVICES ON A PREPAID BASIS. BY FACILITATING THE PROVISION OF MEDICAL SERVICE BY PROVIDERS TO ITS MEMBER ON A PREPAID BASIS, SCOTT & WHITE HEALTH PLAN PROMOTES HEALTH IN FURTHERANCE OF ITS CHARITABLE PURPOSE. THE PROMOTION OF HEALTH AS "CHARITABLE" PURPOSE WITHIN THE MEANING OF SECTION 501(C) (3) IS WELL ESTABLISHED IN REG. SEC.1.501(C)(3)-1(D) EASTERN KENTUCKY WELFARE RIGHTS ORGANIZATION V SIMON506 F2D 1278 (DC CIR. 1974), VACATED ON OTHER GROUNDS, 426 US 26, 46 (1975) AND RESTATEMENT (SECOND) OF TRUST SECTION 368. THE SERVICE HAS LONG HELD THAT SUCH PREMIUMS RECEIVED BY A HEALTH MAINENANCE ORGANIZATION ARE EXEMPT FUNCTION INCOME (SEE GMC 39829, 8/30/1990) 764006 19274708 PBM REVENUE: INTERNAL REVENUE SHOWN ON PRESCRIPTION SERVICES FOR MANAGEMENT OF HEALTH PLAN PHARMACEUTICAL BENEFITS. THE RELATED EXPENSE IS SHOWN ON EACH OF THE INDIVIDUAL PHARMACIES.REBATES: REBATES RECEIVED FROM PHARMACEUTICAL COMPANIES FOR HEALTH PLAN MEMBERS WITH A PRESCRIPTION DRUG BENEFIT.NET INCOME FROM SALES OF PHARMACY INVENTORY AND MISCELLANEOUS INCOME 512318066 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 3568 0 1 0 1 1 0 0 0 0 0 0 0 X 12 10 1 0 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MARINAN RENZ WILLIAMS 2547243000 2401 S 31ST STREET TEMPLE TX 76508 X DONALD RICHARD GROBOWSKY 1.00 X X 0 0 0 A AVOTIS AVOTINS 1.00 X 0 536156 53462 LILLIAN ANN WOLF FARRIS 1.00 X 0 0 0 GARLYN SHELTON 1.00 X 0 0 0 ALFRED BISHOP KNIGHT 1.00 X 0 1329511 51157 ROBERT KEIFER MARSHALL JR 1.00 X 0 0 0 JEFFREY MICHAEL HUNTER 1.00 X 0 0 0 JANANN WILLIAMS 1.00 X 0 0 0 GAIL LENORE PEEK 1.00 X 0 0 0 LOUIS STANLEY CASEY JR 1.00 X 0 0 0 CLYDE GAMRELL SANSING JR 1.00 X 0 0 0 PHILIP EUGENE SCANIO 1.00 X 0 0 0 ALLAN FREDERICK EINBODEN JR 40.00 X 0 575517 51606 MARINAN RENZ WILLIAMS 40.00 X 0 331185 42861 HARVEY FLOYD LITMAN 40.00 X 0 333559 55069 MARYLOU BUYSE 40.00 X 0 331348 20617 REBECCA PRESTON 40.00 X 0 283587 38781 LEE GREEN 40.00 X 0 244415 45621 DAVID TROY STILLWAGON 40.00 X 0 199139 42030 JOHN CHADDICK 40.00 X 0 198140 40279 RENEE MERCER 40.00 X 0 193849 35531 MICHELLE DELEGRAM 32.00 X 178125 0 0 178125 4556406 477014 1 1 1 0 DPR CONSTRUCTION INC 9606 MOPAC EXPRESSWAY N SUITE 300 AUSTIN TX 78759 CONSTRUCTION 11588683 HEALTH INTEGRATED 10008 N DALE MABRY HWY STE 214 TAMPA FL 33618 CONDITION MANAGEMENT 5547563 AXIOM SYSTEMS 241 E FOURTH STREET SUITE 120 FREDERICK MD 21701 INFORMATION SYSTEMS SUPPORT 3065816 HC&B 701 BRAZOS SUITE 1450 AUSTIN TX 78701 ADVERTISING 2697058 HCC LIFE INSURANCE COMPANY 11100 WAYZATA BLVD SUITE 350 MINNETONKA MN 55343 REINSURANCE 1687919 5 MEMBER PAYMENTS 524114 550034841 550034841 ADMINISTRATIVE SERVICE 541610 4796523 4718689 77834 PBM REVENUE 541610 3481862 3481862 METLIFE ADMINISTRATIVE 541610 952127 952127 PBM TAXABLE REVENUE 541610 854296 854296 752895 178465 574430 560872544 1398606 1398606 14144207 13799746 344461 344461 344461 66176807 54235272 11941535 8428334 3513201 MISCELLANEOUS INCOME 524298 8478 8478 COMMISSION REVENUE FRO 524298 193 193 8671 574565817 566850862 5971888 1743067 495674395 495674395 5460074 5460074 146602 146602 413709 413709 273608 273608 45119657 8851643 36268014 4008771 4008771 9079507 9079507 3174186 3174186 2317604 2317604 367780 367780 139276 139276 53750 53750 66036 66036 454348 454348 STATE PREMIUM/MAINTENAN 4694467 4694467 TEXAS RISK POOL ASSESSM 2262797 2262797 A&G - OVERHEAD ALLOCATI 1983518 1983518 DUES, FEES, & SUBSCRIPT 838126 3300 834826 REBATE EXPENSE 763493 763493 237143 67971 169172 577528847 512318066 65210781 0 -4948211 -6618630 13730385 3389355 89061974 83981505 5530007 6399960 732627 822042 19588300 296551 5757304 19291749 37126769 36530599 2861829 3047603 6248086 7617985 156100770 154462168 71730024 77898875 12149691 5957262 83879715 83856137 X 0 0 0 0 72221055 70606031 72221055 70606031 156100770 154462168 X -2963030 1348006 X X 0 1 1 X 0 1681496 1681496 17359617 42288 17317329 547187 254263 292924 19291749 574565817 577528847 -2963030 1348006 1348006 -1615024 X X X X 0 0 0 0 0 0 0 0 0 A AVOTIS AVOTINS 0 513786 0 20537 0 1833 0 31850 0 21612 0 589618 0 0 ALFRED BISHOP KNIGHT 0 926712 0 400000 0 2799 0 31850 0 19307 0 1380668 0 0 ALLAN FREDERICK EINBODEN JR 0 423860 0 151000 0 657 0 31850 0 19756 0 627123 0 0 MARINAN RENZ WILLIAMS 0 274172 0 55180 0 1833 0 31850 0 11011 0 374046 0 0 HARVEY FLOYD LITMAN 0 266926 0 65700 0 933 0 31850 0 23219 0 388628 0 0 MARYLOU BUYSE 0 286222 0 42406 0 2720 0 0 0 20617 0 351965 0 0 REBECCA PRESTON 0 240698 0 41896 0 993 0 31850 0 6931 0 322368 0 0 LEE GREEN 0 217827 0 24755 0 1833 0 31850 0 13771 0 290036 0 0 DAVID TROY STILLWAGON 0 171808 0 26674 0 657 0 26416 0 15614 0 241169 0 0 JOHN CHADDICK 0 165287 0 31020 0 1833 0 25876 0 14403 0 238419 0 0 RENEE MERCER 0 161171 0 32231 0 447 0 25644 0 9887 0 229380 0 0 MICHELLE DELEGRAM 178125 0 0 0 0 0 0 0 0 0 178125 0 0 0 MICHELLE DELEGRAM FORMER ASSOC EXEC DIR/FIN 178125 SEE PART V 0 SCHEDULE L, PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS A FORMER ASSOCIATE EXECUTIVE DIRECTOR OF FINANCE, A. MICHELLE DELEGRAM, PROVIDED CONSULTING SERVICES PRIMARILY RELATED TO PART D BUSINESS TO THE ORGANIZATION DURING 2010. FORM 990, PART VI, SECTION A, LINE 1 THERE ARE 13 VOTING MEMBERS OF THE GOVERNING BODY, HOWEVER THERE WAS ONE VACANCY AT THE END OF THE TAX YEAR FORM 990, PART VI, SECTION A, LINE 2 THREE OF OUR BOARD MEMBERS ARE ALSO BOARD MEMBERS OF ANOTHER CORPORATION WITH WHICH THE HEALTH PLAN CONDUCTS BUSINESS. FORM 990, PART VI, SECTION A, LINE 4 THE CERTIFICATE OF FORMATION AND BYLAWS WERE AMENDED TO RECOGNIZE THAT SCOTT & WHITE HEALTHCARE HAS BECOME THE SOLE MEMBER OF THE ORGANIZATION FORM 990, PART VI, SECTION A, LINE 6 SCOTT & WHITE HEALTHCARE 26-4532547, A 501(C)(3), BECAME THE SOLE CORPORATE MEMBER OF SCOTT & WHITE HEALTH PLAN ON AUGUST 22, 2010. FORM 990, PART VI, SECTION B, LINE 11 THE RETURNS WERE DISTRIBUTED ELECTRONICALLY TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW PRIOR TO THE FILING DEADLINE. FORM 990, PART VI, SECTION B, LINE 12C AT THE FIRST BOARD MEETING OF EACH YEAR, OFFICERS AND DIRECTORS ARE REQUIRED TO CERTIFY THAT THEY HAVE READ AND ARE AWARE OF THE CONFLICT OF INTEREST POLICY. ANY CONFLICTS THAT ARE DISCLOSED AT THAT TIME ARE REVIEWED BY LEGAL COUNSEL IN CONJUNCTION WITH THE CEO AND BOARD PRESIDENT TO DETERMINE IN WHICH TRANSACTIONS, IF ANY, THE CONFLICTED OFFICER OR DIRECTOR MAY NOT PARTICIPATE. TRANSACTION IN WHICH POTENTIAL CONFLICTS MAY ARISE ARE REVIEWED THROUGHOUT THE YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION REVIEW PROCESS IS PERFORMED ANNUALLY. ALL OFFICERS, KEY EMPLOYEES, AND HIGHLY COMPENSATED INDIVIDUALS ARE INCLUDED IN THE REVIEW, AS ARE ALL STAFF. THE PROCESS UTILIZES VARIOUS COMPARATIVE DATA WITH RESPECT TO SIMILAR ORGANIZATIONS. THE PROCEDURES, RATIONALE, AND RESULTS OF THE PROCESS ARE DOCUMENTED AND RETAINED. RECOMMENDED SALARIES AND TOTAL COMPENSATION ARE REVIEWED BY INDEPENDENT COMPENSATION CONSULTANTS AND APPROVED BY THE COMPENSATION COMMITTEE OF THE SCOTT & WHITE HEALTHCARE BOARD OF TRUSTEES. THE ENTIRE BOARD REVIEWS AND APPROVES THE RECOMMENDATIONS OF THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 1023 AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVEDED TO INDIVIDUALS UPON REQUEST. FORM 990, PART VII: COMPENSATION AVERAGE HOURS PER WEEK RECORDED IN COLUMN B FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES REPRESENT TOTAL HOURS WORKED FOR THE ENTIRE SCOTT & WHITE HEALTHCARE SYSTEM. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: UNREALIZED GAINS AND LOSSES 1,348,006. TOTAL TO FORM 990, PART XI, LINE 5: 1,348,006. PART XII, LINES 2 A & B: FINANCIAL STATEMENTS AND REPORTING - THE ORGANIZATION HAD A STATUTORY-BASIS AUDITED FINANCIAL STATEMENT IN 2010, BUT DID NOT HAVE A SEPARATE AUDITED FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH GAAP. PART V, LINE 2A: STATEMENTS REGARDING OTHER IRS FILINGS AND TAX COMPLIANCE NUMBER OF EMPLOYEES OF THE SCOTT & WHITE HEALTHCARE SYSTEM AFFILIATES ARE EMPLOYED BY SCOTT & WHITE MEMORIAL HOSPITAL 74-1166904 OR SCOTT & WHITE CLINIC 74-2958277. THIS IS DONE TO ACHIEVE PARITY AND CONSISTENCY IN COMPENSATION AND BENEFITS OFFERED TO EMPLOYEES AND TO REDUCE ADMINISTRATIVE COSTS. CONSISTENT WITH THIS PRACTICE, EMPLOYEE FORM W-2'S ARE FILED BY SCOTT & WHITE MEMORIAL HOSPITAL OR SCOTT & WHITE CLINIC. FOR FINANCIAL REPORTING PURPOSES, COMPENSATION, BENEFITS, AND OTHER EMPLOYEE COSTS ARE ASSIGNED TO THE SCOTT & WHITE AFFILIATE FOR WHICH SERVICES ARE PROVIDED AND ARE REPORTED AS EXPENSES OF SUCH AFFILIATES, AS SEEN IN PART IX, STATEMENT OF FUNCTIONAL EXPENSES. ALL REQUIRED EMPLOYMENT FORMS HAVE BEEN FILED BY SCOTT & WHITE MEMORIAL HOSPITAL AND SCOTT & WHITE CLINIC. SCOTT & WHITE HEALTHCARE 2401 S 31ST STREET TEMPLE TX 76508 264532547 HEALTHCARE TX 501(C)(3) LINE 11A, I N/A 0 SCOTT & WHITE MEMORIAL HOSPITAL 2401 S 31ST STREET TEMPLE TX 76508 741166904 HOSPITAL TX 501(C)(3) LINE 3 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE CLINIC 2401 S 31ST STREET TEMPLE TX 76508 742958277 CLINIC TX 501(C)(3) LINE 9 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE HOSPITAL - ROUND ROCK 2401 S 31ST STREET TEMPLE TX 76508 203749695 HOSPITAL TX 501(C)(3) LINE 3 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE HEALTHCARE FOUNDATION 2401 S 31ST STREET TEMPLE TX 76508 273513154 FUNDRAISING TX 501(C)(3) LINE 7 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE CONTINUING CARE HOSPITAL 2401 S 31ST STREET TEMPLE TX 76508 202850920 HOSPITAL TX 501(C)(3) LINE 3 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE HOSPITAL - TAYLOR 2401 S 31ST STREET TEMPLE TX 76508 741595711 HOSPITAL TX 501(C)(3) LINE 3 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE HOSPITAL - LLANO 2401 S 31ST STREET TEMPLE TX 76508 273026151 HOPSITAL TX 501(C)(3) LINE 3 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE HOSPITAL - BRENHAM 2401 S 31ST STREET TEMPLE TX 76508 742519752 HOSPITAL TX 501(C)(3) LINE 3 SCOTT & WHITE HEALTHCARE 1 BRENHAM CARE CLINIC 2401 S 31ST STREET TEMPLE TX 76508 742663229 HOSPITAL TX 501(C)(3) LINE 9 SCOTT & WHITE HEALTHCARE 1 BRENHAM HOSPITAL SERVICES CORPORATION 2401 S 31ST STREET TEMPLE TX 76508 742605157 HEALTHCARE TX 501(C)(3) LINE 11A, I SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE FOUNDATION - BRENHAM 2401 S 31ST STREET TEMPLE TX 76508 742460815 FUNDRAISING TX 501(C)(3) LINE 7 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE HOSPITAL - COLLEGE STATION 2401 S 31ST STREET TEMPLE TX 76508 274434451 HOSPITAL TX 501(C)(3) LINE 3 SCOTT & WHITE HEALTHCARE 1 SCOTT & WHITE EMS INC 2401 S 31ST STREET TEMPLE TX 76508 753242749 EMERGENCY TRANSPORTATION TX 501(C)(3) LINE 9 SCOTT & WHITE HEALTHCARE 1 HILLCREST BAPTIST MEDICAL CENTER 100 HILLCREST MEDICAL BLVD WACO TX 76708 741161944 HOSPITAL TX 501(C)(3) LINE 3 SCOTT & WHITE MEMORIAL HOSPITAL 1 HILLCREST FAMILY HEALTH CENTER 100 HILLCREST MEDICAL BLVD WACO TX 76708 742730350 HEALTHCARE TX 501(C)(3) LINE 11C, III-FI HILLCREST BAPTISTS MED CTR 1 HILLCREST HOSPITAL SPECIALISTS 100 HILLCREST MEDICAL BLVD WACO TX 76708 742967081 PHYSICIAN SERVICES TX 501(C)(3) LINE 11C, III-FI HILLCREST BAPTISTS MED CTR 1 INSURANCE COMPANY OF SCOTT & WHITE 2401 S 31ST STREET TEMPLE TX 76508 743092083 INSURANCE CO TX SCOTT AND WHITE HEALTH PLAN C 137857 3047957 1.00000 SCOTT & WHITE ASSURANCE 23 LIME BAY GRAND CAYMAN CJ 980589956 CAPTIVE INSURANCE COMP CJ C SCOTT & WHITE PROPERTIES INC 2401 S 31ST STREET TEMPLE TX 76508 742497061 HOTEL SERVICES TX C HILLCREST HEALTH HOLDINGS INC 2401 S 31ST STREET TEMPLE TX 76508 742793367 ADMINISTRATION TX C ATUMIDA 2401 S 31ST STREET TEMPLE TX 76508 270583030 RESEARCH TX C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 INSURANCE COMPANY OF SCOTT & WHITE O 552856 FAIR MARKET VALUE INSURANCE COMPANY OF SCOTT & WHITE P 211086 FAIR MARKET VALUE SCOTT & WHITE MEMORIAL HOSPITAL J 42832230 FAIR MARKET VALUE SCOTT & WHITE MEMORIAL HOSPITAL O 106351212 FAIR MARKET VALUE INSURANCE COMPANY OF SCOTT & WHITE IS A WHOLLY OWNED SUBSIDIARY OF SCOTT & WHITE HEALTH PLAN. SCOTT & WHITE HEALTH PLAN AND THE INSURANCE COMPANY OF SCOTT & WHITE WERE ACQUIRED BY SCOTT & WHITE HEALTHCARE. SCOTT & WHITE HEALTHCARE IS A PARENT ORGANIZATION OF VARIOUS SCOTT & WHITE ENTITIES.